- No sign yet
Details and sources
- Promised
- FAST launched its 2025 manifesto on Saturday 12 July 2025 at Apita o Pisaga Hall, Salelologa, Savaiʻi 2. That same day the Samoa Observer listed free hospital services first among the pledges 1. RNZ on 22 July 2025 and Devpolicy on 25 August 2025 reported the pledge as free public hospital services 45. None of these reports gives an amount, a start date or a costing 145. On 28 August 2025, the day before the vote, a Samoa Observer summary described a narrower pledge: free medical visits and medicine for pregnant women, children, older people and people with disabilities 6. The health summary in that Samoa Observer article listed insurance for all, a new Salelologa hospital and free visits for schoolchildren, pensioners and people with disabilities 7. Most of that narrower pledge already existed before the election 363940. A 2023 Ministry of Finance policy lists free medical consultation for pregnant women and children, and free medicines for non-communicable diseases (NCDs) 3940. The National Provident Fund gives people aged 65 and over free consultations at government hospitals and free medicines at government pharmacies 3637. Talamua's report on the launch named Family Health as one focus of a ten-point plan, but it did not mention free hospital care 3. Samoa Global News gave amounts for many pledges, such as SAT$300 million for Samoa Airways, but did not mention free hospital services 8. We did not find the manifesto document itself, so FAST's own wording and how far the pledge reaches are unconfirmed. On 13 July 2025 a Samoa Observer editorial said FAST had not set out how it would pay for its promises 9. The Samoa Uniting Party also promised free hospital care 10.
- What happened
- We found no law, regulation, budget line or ministry notice removing hospital fees between 16 September 2025 and 22 October 2026. Under the Ministry of Health Act 2006, Ministry fees are set in regulations 11. Parliament's legislation page lists no new regulations in 2026 12. The 2025/26 Budget Address, given on 6 October 2025, called healthcare subsidised, not free 13. The 2026/27 Budget Address, given on 26 May 2026, set the Ministry of Health budget at SAT$183,429,092 1456. The 2026/27 Budget Address raised funding for medical consumables from SAT$14 million to SAT$21.5 million 15. Part of that money is to settle unpaid supplier bills 16. The 2026/27 Approved Estimates still expect the Ministry to collect SAT$970,000 from TTM Hospital clinical services and SAT$600,000 from MTII Hospital services. Both amounts are the same as in 2025/26 1718. In the 2025/26 Estimates, expected TTM Hospital fee income was SAT$970,000, down from SAT$1,500,000 in 2024/25 22. Total expected Ministry revenue fell to SAT$4,500,000 from SAT$5,510,839 23. The Estimates do not say why. We found no notice of a fee cut, and the statistics office shows the same nightly hospital charge in 2024 and 2025 222328. In the nine months to 31 March 2026, the Ministry collected SAT$1,944,987, against SAT$4,500,000 budgeted for the full year 24. The government's cash-flow statement shows SAT$2,835,014 collected in the same nine months a year earlier, to 31 March 2025 25. The statement does not explain the fall 25. In a report to the United Nations dated 18 September 2026, the government called basic public health services subsidised or free 42. The UN report said children under 15, people with disabilities and pensioners are entitled to free care 41. A government press release of 3 July 2026 on commitments delivered from 1 July 2026 does not mention hospital fees 26. A Samoa Observer review on 15 September 2026 said several of the government's biggest election pledges were still unfulfilled 27. The rest of that review is behind a paywall, so we could not read what it says about health 27.
- Impact on families
- The Samoa Bureau of Statistics lists the average hospital charge at SAT$22.50 a night in every year from 2021 to 2025 28. We could not confirm the 2026 charge from a published report. In the same table, a private doctor's consultation for an adult averaged SAT$30.00 in each of those years 29. Health prices as a whole rose 4.2% in the year to September 2026 30. The latest public consultation fee we found was SAT$8 for residents over 15, from 1 November 2021 3132. Official sources differ on who already gets free care. The Ministry's 2020 workforce plan says people aged 60 and over and children aged 12 and under pay no hospital or outpatient fees 34. The National Provident Fund puts the age for its free consultations and medicines at 65 3637. The government's September 2026 report to the UN names children under 15, people with disabilities and pensioners 41. The 2026/27 Estimates list free X-ray tests for children under 15, mental health patients, people with disabilities, maternal patients and patients with chronic conditions 2157. In October 2021 the disability group Nuanua O Le Alofa said less than 5% of the people it surveyed knew about free care and could get it 43. Medicine shortages have added costs for families 46. In June 2026, RNZ reported that the main hospital was rationing medicine 44. RNZ cited local reports that a SAT$12 million backlog in unpaid supplier bills was one factor 45. In July 2026 a father of six told ABC Pacific that prescriptions he used to get for SAT$5 at the hospital pharmacy now cost him more than SAT$200 in total at private pharmacies 46. On 24 July 2026 ABC Pacific reported the Health Minister as saying the shortage was the result of the previous government's failure to settle debts with overseas suppliers 47. This is the Minister's claim, not a finding. In a letter published on 12 November 2025, the Minister had linked shortages to disruptions in global shipping, higher freight costs and delays in making medicines since COVID-19 58. In the same letter he wrote that Cabinet had asked for an independent audit of the health supply chain 59. We found no published result of that audit, and no reply on the record from the former Health Minister or other members of the previous government. On 20 July 2026 the Samoa Observer, drawing on the government's Savali newspaper, reported the Minister as saying payments for large orders were often delayed because each must first be reviewed by the Government Tenders Board 60. The Minister told ABC Pacific that 104 medicines had become scarce in the government's first nine months, and that nine were still scarce 48. Reports differ on the supplier debts. ABC Pacific reported that around half had been settled 49. The same Samoa Observer report quoted the Minister as saying that payments for orders placed from 2020 to 2025 had been settled 50. The 2020 workforce plan found the Ministry was short of 100 doctors and 226 registered nurses 35. A letter to the editor in the Samoa Observer in November 2025 said 101 of the 145 doctors registered with the Samoa Medical Association were serving in the Ministry 52. We found no fee waived under this promise, so no family has gained from it so far 1718.
- Cost
- We found no costing of free hospital services from FAST or the government 9. Before the vote, the Samoa Observer wrote that health spending was near SAT$160 million, and that the health plans of HRPP and FAST could double it 54. The 2026/27 Estimates expect SAT$4,320,000 from seven hospital, clinical and rural district hospital fee lines. That total is our own sum 171819. It is about 2.4% of the SAT$183,429,092 Health budget 14. Total expected Ministry revenue rises to SAT$6,000,000 in 2026/27 from SAT$4,500,000 in 2025/26 19. The health protection and enforcement line accounts for the whole SAT$1,500,000 rise: it goes to SAT$1,540,000 from SAT$40,000 1920. In 2023/24 the Ministry collected SAT$5,739,396 in fees and charges of all kinds 53. These figures show only the fee income that would be lost. They leave out any rise in use if care becomes free, so they are not a full cost estimate.
- Verdict for families
- Good for aiga
- Can it be done?
- A stretch
- Long term
- Mixed long term
- Who deserves the credit
-
Started by an earlier government
The free care that exists today is inherited: the senior citizens scheme dates from 1990, free care for older people, children and pregnant women is described in 2020 and 2023 government papers, and the SAT$8 consultation fee comes from a 2021 cut first announced in a budget speech of Fiamē's FAST government 3834393233. Laʻauli's government has not removed fees and expects the same clinical fee income in 2026/27 as in 2025/26; its bigger medicines budget is its own decision, but it does not deliver this promise, and part of it pays earlier supplier bills 17181516.
- Who gains
- If delivered, working-age adults outside the free groups would gain most: the hospital charge averaged SAT$22.50 a night in 2025, and the consultation fee was SAT$8 a visit when last reported in 2021 2831.
- Who pays
- Taxpayers would replace about SAT$4.32 million a year in fee income in the 2026/27 Estimates, from a Health budget that the Health Minister was reported in July 2026 as saying would not cover future medicine orders 17181951.
- Assessment
- Free care at the door, paid from tax, would help working-age and low-income adults who still pay hospital and pharmacy charges, so the promise lands as good if delivered 283118. The fee income at stake is small, about SAT$4.32 million a year by our sum of the 2026/27 Estimates, so the money itself is within reach 17181914. The promise is still a stretch because medicines and staff are short 3544. In July 2026 the Health Minister was reported as saying the Health budget would not cover future medicine orders 51. The long-term outlook is mixed: free visits with empty shelves still send families to private pharmacies, and a 2013 World Bank review already doubted that health spending could be kept up 4655. We mark it stalled, not broken, because no deadline was set and the fee rules have not changed 1451112.
Sources (60)
- FAST manifesto: Free hospital, money for poor and launch of stock exchange
- FAST Party Manifesto Centres on the Family Unit
- FAST Party Manifesto Centres on the Family Unit
- Samoa election: Political parties make big promises on health, welfare and economy
- Gearing up for the 2025 Samoan general election
- What the three major parties are promising Samoa
- What the three major parties are promising Samoa
- FAST Manifesto Promises Tax Cuts and Support to Industry
- More promises, FAST and its manifesto
- Samoa election: Political parties make big promises on health, welfare and economy
- Ministry of Health Act 2006
- Bills, Acts and Regulations – Parliament of Samoa
- Budget Address 2025/2026
- Budget Address 2026/2027
- Budget Address 2026/2027
- Budget Address 2026/2027
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2025-26 (Approved Budget Document FY25-26)
- Estimates for the Financial Year 2025-26 (Approved Budget Document FY25-26)
- Statement of Cash Flows for the 9 months ended 31st March 2026
- Statement of Cash Flows for the 9 months ended 31st March 2026
- Government Delivers on Key Social Commitments from 1 July 2026
- FAST Government one year on: What has been delivered and what remains
- Statistical Abstract 2025
- Statistical Abstract 2025
- Consumer Price Index (September 2026)
- Hospital consultation fees reduced
- Hospital consultation fees reduced
- Hospital consultation fees reduced
- Samoa Health Workforce Development Plan Financial Years 2020/21–2025/26
- Samoa Health Workforce Development Plan Financial Years 2020/21–2025/26
- Senior Citizens Benefit Fund
- Senior Citizens Benefit Fund
- Senior Citizens Benefit Fund
- National Social Protection Policy Framework 2023
- National Social Protection Policy Framework 2023
- National report submitted pursuant to Human Rights Council resolutions 5/1 and 16/21: Samoa (A/HRC/WG.6/53/WSM/1)
- National report submitted pursuant to Human Rights Council resolutions 5/1 and 16/21: Samoa (A/HRC/WG.6/53/WSM/1)
- This statement is delivered on behalf of Nuanua O Le Alofa
- Samoa's main hospital rationing medicine amid critical shortage
- Samoa's main hospital rationing medicine amid critical shortage
- Samoa health system grapples with medicine supply
- Samoa health system grapples with medicine supply
- Samoa health system grapples with medicine supply
- Samoa health system grapples with medicine supply
- Health Minister: Budget not enough for future medicine orders
- Health Minister: Budget not enough for future medicine orders
- Clarifying facts Samoa's doctor workforce
- Ministry of Health Annual Report FY2023/2024
- What the three major parties are promising Samoa
- Health-Financing Options for Samoa: Challenges and Opportunities
- Samoa Government tables $1.5 billion budget with focus on fuel crisis, pensions and child support
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Samoa government response: Strengthening Samoa’s health system beyond short-term supply challenges
- Samoa government response: Strengthening Samoa’s health system beyond short-term supply challenges
- Health Minister: Budget not enough for future medicine orders
Is it funded?
No budget line
We searched the 2025/26 and 2026/27 Budget Addresses and the Ministry of Health votes in the 2025/26 and 2026/27 Approved Estimates. None has a line for free hospital services or for replacing fee income 1458. The 2025/26 Budget Address calls healthcare subsidised 1. The 2025/26 Address also says the government did not plan a supplementary budget 3. The 2026/27 Estimates still expect SAT$970,000 a year in fees from TTM Hospital clinical services 5. In both years, free care for some groups appears only as a target for the number of X-ray tests, with no money attached 67. In the 2025/26 Estimates, expected TTM Hospital fee income fell to SAT$970,000 from SAT$1,500,000 8. Total expected Ministry revenue fell to SAT$4,500,000 from SAT$5,510,839. No reason is given 9. The Ministry of Health budget was SAT$170,675,414 in 2025/26 2. By 31 March 2026, SAT$114,884,122 of it had been spent 10. The Ministry of Health budget is SAT$183,429,092 in 2026/27 4. The latest spending report we read covers the nine months to 31 March 2026 10. We found no money paid out for this promise.
Sources (10)
- Budget Address 2025/2026
- Budget Address 2025/2026
- Budget Address 2025/2026
- Budget Address 2026/2027
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2025-26 (Approved Budget Document FY25-26)
- Estimates for the Financial Year 2025-26 (Approved Budget Document FY25-26)
- Estimates for the Financial Year 2025-26 (Approved Budget Document FY25-26)
- Statement of Cash Flows for the 9 months ended 31st March 2026
What research says
Research is mixed
In Samoa, a 2013 World Bank review found that almost free public care had protected nearly all citizens from very large health bills 1. The World Bank review also warned that poorer people may simply go without care 2. The review found that fees covered just 0.08% of government health spending in 2011/12 3. A World Bank study published in 2021 named the supply of blood-pressure medicines as a major barrier to treatment in Samoa 4. The 2021 study found patients spent on average SAT$50 a month on chronic care, just over 5% of average monthly income 5. Fiji gave free price-controlled medicines to people earning under FJ$20,000 a year, with FJ$8.0 million in its 2015 budget 6. We found no evaluation of the Fiji scheme that we could read. A 2022 Cochrane review of user fees in low- and middle-income countries found mixed results and very low-quality evidence 7. The Cochrane review also warned that removing fees may have side effects on preventive care and on quality 8. A 2013 review of fee exemptions for maternal care said governments should replace the income that health facilities lose 9. Most of this evidence comes from outside the Pacific. Public care in Samoa is already close to free, so the gain for families depends more on medicines and staff being there than on the fee itself 149.
Sources (9)
- Health-Financing Options for Samoa: Challenges and Opportunities
- Health-Financing Options for Samoa: Challenges and Opportunities
- Health-Financing Options for Samoa: Challenges and Opportunities
- Improving Services for Chronic Non-communicable Diseases in Samoa: An Implementation Research Study Using the Care Cascade Framework
- Improving Services for Chronic Non-communicable Diseases in Samoa: An Implementation Research Study Using the Care Cascade Framework
- Free Medicine Program
- The impact of user fees on access to health services in low- and middle-income countries
- The impact of user fees on access to health services in low- and middle-income countries
- Effects of User Fee Exemptions on the Provision and Use of Maternal Health Services: A Review of Literature
Cost and reach
There is no official cost. We take the yearly cost as the clinical fee income the Ministry expects to collect in 2026/27 123. There are seven lines: SAT$970,000 from TTM Hospital, SAT$300,000 from the laboratory, SAT$300,000 from imaging, SAT$392,750 from dental, SAT$1,500,000 from the pharmacy, SAT$600,000 from MTII Hospital and SAT$257,250 from rural district hospitals 123. Together they come to SAT$4,320,000, which is our own sum 123. In 2023/24 the Ministry collected SAT$5,739,396 in fees and charges of all kinds 4. In the nine months to 31 March 2026, the Ministry collected SAT$1,944,987 5. A 2013 World Bank review put fee income at just 0.08% of government health spending in 2011/12 6. That share is far below what the newer figures suggest, and the sources do not explain the gap 46. Any rise in use after fees are removed would add to the cost. No count of patients who pay fees is published, so the number of people reached is unknown.
Sources (6)
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Estimates for the Financial Year 2026-27 (Approved Budget Document FY26-27)
- Ministry of Health Annual Report FY2023/2024
- Statement of Cash Flows for the 9 months ended 31st March 2026
- Health-Financing Options for Samoa: Challenges and Opportunities
Helps: Wage workers · Low-income families · Rural villages and Savaiʻi · Every household alike
Paid for by: Taxpayers
Folafolaga · https://folafolaga.pages.dev/promises/fast-health-free-hospital/ · Printed from the version last checked 23 October 2026. Every claim's source is listed on that page.